The UK government’s ten-year health plan promises a radical digital transformation of the NHS. A key part of this change is said to come from developing the NHS app, which is being hailed as a “doctor in your pocket”.
The upgraded app will apparently offer features like instant health advice, appointment booking, prescription management and access to personal health records. It is hoped the software will become users’ “front door” to the NHS.
It’s an ambitious vision which aims to empower patients, streamline services and reduce red tape. And for tech-savvy users, these innovations could significantly improve access to care, reduce waiting times and enhance patient autonomy.
But while it may herald a new era of convenience for many, it risks leaving behind anyone who struggles with an increasingly digital world. This could then exacerbate health inequalities which already exist – and increase pressure on some areas of already strained services.
In particular, a digital-first approach to healthcare risks excluding older adults, who may lack the skills or resources to confidently navigate the necessary software. The media regulator Ofcom estimates that around 6% of UK households still lack internet access at home. Figures from the charity Age UK suggest that 33% of people over 75 in the UK lack basic digital skills.
With regard to health specifically, a 2024 study found that older patients were more likely to misunderstand automated symptom checkers, leading to unnecessary anxiety or delayed care.
For these people, the planned shift to app-based services could create new barriers to accessing care, potentially leading to delayed diagnoses and worsening health outcomes.
The NHS plan does at least acknowledge this divide, and says it will confer with patient groups and work with other establishments (such as libraries) to support digital literacy. But these measures will not be enough without guaranteed funding.
And older people, even those who are comfortable with technology, may face other challenges such as visual impairment or cognitive decline, which can make using apps difficult.
Others who struggle to use the NHS App for routine care may delay seeking help until their conditions worsen, placing avoidable strain on overstretched hospitals.
Digital diversion
This strain might include digital triage inadvertently funnelling non-urgent cases to A&E if users misinterpret symptoms or find the app’s guidance unclear, a risk compounded by the lack of human oversight in automated systems. Or a patient with chronic pain might avoid the app due to digital anxiety or confusion, and end up going to A&E when their condition becomes unbearable and more costly to treat.
Not everyone is comfortable with apps.
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To avoid all of this, the NHS needs to maintain traditional communication options. Telephone and in-person services must remain accessible and widely available. The ten-year plan’s focus on “digital by default” should not become “digital only”.
There should also be plenty of investment to help people feel digitally empowered and included. Places like libraries and community centres can certainly help, but targeted outreach will also be necessary, such as partnerships with charities.
This is not to say the NHS should be overly wary of the benefits of increased digital capabilities. The ten-year plan highlights, for example, the app’s potential to alleviate some of the burdens on healthcare staff, with AI able to take care of admin, saving clinicians time which can be used for patient care instead.
Such efficiencies are critical for a system grappling with workforce shortages and rising demand. Yet if digital tools are not universally accessible or usable, not everyone will benefit.
So while the NHS’s digital ambitions are commendable, their success hinges on inclusivity. If it’s not careful, the system risks entrenching a two-tier system where younger, tech-literate patients benefit while older and disadvantaged groups face greater exclusion. As the NHS embraces innovation, it must ensure no one is left behind – especially those who rely on it the most.
